1499. Gonorrhea and Chlamydia Infections in the Department of Veterans Affairs (VA), 2013-2017
Session: Poster Abstract Session: Sexually Transmitted Infections
Friday, October 5, 2018
Room: S Poster Hall
Posters
  • Tricia ID week 2018 GC-CT poster.pdf (2.2 MB)
  • Gonorrhea and Chlamydia Infections in the Department of Veterans Affairs (VA), 2013-2017

    Background: Gonorrhea (GC) and Chlamydia (CT) infections caused by Neisseria gonorrhoeae and Chlamydia trachomatis, respectively, are an ongoing public health issue. CDC guidelines suggest repeat testing 3-12 months after a positive test result (Workowski, K et al.  MMWR 2010 and 2015).  We investigated national trends and repeat testing practices for patients with GC and CT infection in VA.

    Methods: GC and CT cases were identified from 1/1/2013–12/31/2017 using molecular laboratory testing results from VA data sources.  Patients were reviewed for positive results, repeat testing and demographic characteristics.     

    Results: 10,587 of 641,535 (1.7%) GC results were positive; 27,306 of 648,320 (4.2%) CT results were positive.  Coinfection (GC+CT) was documented in 1,935 tests (1,804 unique patients).  Repeat testing after a positive result ranged from 26% to 31% for GC, CT and GC+CT, respectively (Table).  Number of positive cases and tests performed for GC and CT increased over the last 5 years, however percent positive has been stable for CT but increasing for GC (Figure).    States with the highest total number of positive GC tests were California (1,363), Texas (1,219), and Florida (815), while for CT were Illinois (4,509), California (3,370), and Texas (2,805). 

    Conclusion: GC and CT infections increased between 2013 and 2017 in VA.  Although females comprise 10% of the VA population, they proportionally had increased GC and CT positive results.  VA providers could improve retesting practices 3-12 months post infection for patients with GC and/or CT.

    Table.  Demographic Factors and Repeat Testing in Gonorrhea (GC) and Chlamydia (CT) Infections in VA, 1/1/2013–12/31/2017.

     

    GC

    N=641,535

    CT

    N=648,320

    GC+CT

    N=638,361

    Unique Patients Tested

    414,316

    417,641

    407,708

    Total Positive Results

    10,587

    27,306

    1,935

    Unique Positive Patients

    9,149

    24,257

    1,804

          Female:Male*

    1,109:8,040

    7,600:16,657

    291:1,513

    Average Age (Range)

    40 (17-87)

    31 (13-88)

    36 (17-84)

    Repeat Testing Performed (% of Total Positive Results)

    2,702 (26)

    7,906 (29)

    593 (31)

    *Overall, VA population is 10% female (www.womenshealth.va.gov)

    Any GC/CT test 3-12 months after a positive result

    Figure.  Five Year Trend in Gonorrhea (GC) and Chlamydia (CT) Test Results in VA, 1/1/2013-12/31/2017.

     

    Patricia Schirmer, MD1, Cynthia Lucero-Obusan, MD1, Gina Oda, MS1 and Mark Holodniy, MD, FIDSA, FSHEA1,2, (1)Public Health Surveillance and Research, Department of Veterans Affairs, Palo Alto, CA, (2)Stanford University, Stanford, CA

    Disclosures:

    P. Schirmer, None

    C. Lucero-Obusan, None

    G. Oda, None

    M. Holodniy, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.